The role of emotional abuse in intimate partner violence and health among women in Yokohama, Japan

Emotional violence within intimate partner violence against Turkish women in rural and urban areas

BACKGROUND

The purpose of this study is to determine the factors related to women's exposure to emotional violence by their spouses/partners in the 12 months prior to the survey, according to their place of residence (rural, urban) in Türkiye.

METHODS

Binary logistic regression analysis was utilized to determine the factors associated with women's exposure to emotional violence from their spouses/partners. The independent variables of the study were those used in the National Research on Domestic Violence against Women in Türkiye (2014). A total of 6,458 women-4,404 from urban areas and 2,054 from rural areas-were included in the analysis.

RESULTS

The findings obtained from the analyses indicated that women's exposure to emotional violence was associated with various factors such as age, educational level, marital status, and women's higher income contribution to the household. It was also found that afraid of spouse/partner, controlling behavior of spouse/partner, and other variables related to spouse/partner were associated with women's exposure to emotional violence. In rural, a woman with a higher income contribution to the household is less likely to be exposed to emotional IPV. A woman with no formal education, a primary and secondary school graduate spouse/partner is less likely to be exposed to emotional IPV than a woman with a high school graduate spouse/partner. The likelihood of a woman with a spouse/partner using drugs to be exposed to emotional IPV is lower than a non-user.

CONCLUSIONS

The results of the study are important in that they can be a source of information for policies and programs to prevent IPV against women. This study can also be a significant guide in determining priority areas for the resolution of emotional IPV against women. The study suggests developing proper strategies for reducing emotional violence, such as training and programs to help women pursue non-violent pathways in their relationships. It recommends expanding interventions to empower women economically that help prevent violence.

Intimate Partner Violence Against Women and Workplace Productivity in the Financial Sector of Two Latin American Societies

This research determines the prevalence of intimate partner violence against women (IPVAW) and its impact on labor productivity in the financial sector of two Latin American countries. Nine financial institutions participated in this study with surveys of 892 female employees in Bolivia and 393 in Paraguay. The results revealed that 40.1% in Bolivia and 18.7% in Paraguay experienced IPVAW. In Bolivia, this resulted in 6.686 lost workdays per year due to absenteeism and 7.640 workdays per year due to presenteeism (present but distracted). In Paraguay, 12.035 days were lost to absenteeism and 12.037 to presenteeism. This pioneering research highlights the significant influence of IPVAW on financial sector productivity and its broader economic implications.

Intimate Partner Violence and Mental Distress, Post-Traumatic Stress Symptoms and Life Satisfaction in Colombian Women

Intimate partner violence (IPV) against women is a major global public health and human rights issue, with significant consequences for women's health and well-being. This study aimed to determine the relevance of IPV on women's mental distress, post-traumatic stress symptoms and life satisfaction, and to examine whether age, education, socioeconomic status, social support and self-esteem are associated with mental health and well-being. The sample consisted of 255 women aged 18 to 71 living in Colombia who were assessed using six self-reported questionnaires. Hierarchical multiple regression analyses showed that more IPV was associated with women's increased mental distress, post-traumatic stress symptoms and decreased life satisfaction. Although self-esteem and, to a lesser extent, social support were important predictors of women's mental distress and well-being, psychological IPV was the main predictor of women's post-traumatic stress symptoms, followed by lower self-esteem and younger age. The most important predictor of women's mental distress was lower self-esteem, followed by more psychological IPV and lower social support. The main predictor of women's life satisfaction was high self-esteem, followed by high social support, less psychological IPV and higher age and education. It is concluded that IPV, especially psychological IPV, is a serious threat to women's mental health and well-being, while high self-esteem and, to a lesser extent, high social support are associated with better mental health and well-being.

Intimate Partner Violence Against Women and Labor Productivity: The Mediating Role of Morbidity

This study determines that morbidity presents a mediating impact between intimate partner violence against women and labor productivity in terms of absenteeism and presenteeism. Partial least squares structural equation modeling (PLS-SEM) was used on a nationwide representative sample of 357 female owners of micro-firms in Peru. The resulting data reveals that morbidity is a mediating variable between intimate partner violence against women and absenteeism (β = 0.213; p < .001), as well as between intimate partner violence against women and presenteeism (β = 0.336; p < .001). This finding allows us to understand how such intimate partner violence against women negatively affects the workplace productivity in the context of a micro-enterprise, a key element in many economies across the world.

Receiving threatening or obscene messages from a partner and mental health, self-harm and suicidality: results from the Adult Psychiatric Morbidity Survey

PURPOSE

Threatening or obscene messaging is repeated, unwanted texts, emails, letters or cards experienced by the recipient as threatening or obscene, and causing fear, alarm or distress. It is rarely examined as an aspect of intimate partner violence. We describe the prevalence of exposure to threatening/obscene messaging from a current or ex-partner; characteristics of victims; and associations with other forms of violence and abuse, mental disorder, self-harm, and suicidality.

METHODS

Cross-sectional probability-sample survey of the general population in England aged 16 + . Multivariable regression modelling tested associations between receipt of threatening/obscene messaging and current common mental disorder, past-year self-harm and suicidality.

RESULTS

Threatening/obscene messages were received from a current/ex-partner by 6.6% (95%CI: 5.9-7.3) of adults who had been in a relationship; 1.7% received these in the past year. Victims were more likely to be female, under 35, single or divorced, socioeconomically disadvantaged, and to have experienced other forms of sexual and partner violence and abuse. Those who received threatening/obscene messages in the past year were more likely to experience common mental disorder (adjusted odds ratio 1.89; 1.01-3.55), self-harm (2.31; 1.00-5.33), and suicidal thoughts (2.00; 1.06-3.78).

CONCLUSION

Threatening/obscene messaging commonly occurs in the context of intimate partner violence. While often occurring alongside sexual and physical violence, messaging has an additional association with mental disorder and suicidality. Routine enquiry in service settings concerning safety, including those working with people who have escaped domestic violence, should ask about ongoing contact from previous as well as current partners. This should include asking about messaging, as well as other forms of potentially technology-enabled abuse which may become increasingly common.

The prevalence of sexual violence against African women: a systematic review and meta-analysis

Background

High rates of sexual violence ratios in low-income countries are recognized as a global public health problem. The incidence of violence against African women has been increasing. However, no study has systematically summarized the global prevalence of sexual violence against African woman.

Methods

We conducted a comprehensive search of PubMed, Embase and Web of Science, databases from their inception through January 2021 for pertinent studies on reporting the prevalence of sexual violence against African women. We included observational studies. The prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study level characteristics were estimated through subgroup analysis and meta-regression.

Results

A total of 9 cross-sectional studies were included (a total of 9,030 participants). The pooled sexual violence rate was 0.33 (95% CI = 0.23-0.42). Subgroup analyses found that there was a higher rates of sexual violence against pregnant woman in east Africa (0.41, 95% CI = 0.24-0.58), pregnant (0.42, 95% CI = 0.05-0.80), and interview (0.40, 95% CI = 0.01-0.78). The analysis found that the major sexual violence types were the physical violence (0.19, 95% CI = 0.07-0.31), psychological violence (0.36, 95% CI = 0.11-0.61), sexual assault (0.25, 95% CI = 0.02-0.47).

Conclusions

Nearly one out of every three (33%) African woman around the world has been a victim of sexual violence in their life. This current study investigated the status and characteristics of sexual violence against women, which could provide an important reference for the African health care provider. Assessing this problem against African women helps government officials, policy makers, program designers and non-governmental organizations to design prevention and controlling strategies.

Factors Associated With Domestic Violence Against Peri- and Postmenopausal Women

The goal of the study was to determine factors associated with domestic violence in menopausal women. This was a cross-sectional study that 350 menopausal women participated. Data gathering used a World Health Organization's violence against women instrument. Emotional violence was recognized as one of the most experienced types of domestic violence (48%). According to the multivariate logistic regression model, the status of exposure to sexual violence (before marriage) and the partner's substance abuse was the most robust risk factors for domestic violence, while factors such as employment of women and satisfaction of income were protective against domestic violence. This study has highlighted the factors associated with domestic violence that health program managers need to address.

Sexual violence against women remains problematic and highly prevalent around the world

BACKGROUND

Sexual violence is far more prevalent in most societies than is usually suspected in daily life. However, no study has systematically summarized the global prevalence rate and the major outcomes of sexual violence against women.

METHODS

We directed a wide-raging search in the PubMed, Embase, and Web of Science, catalogs since the beginning to December 2022 for relevant reports about the incidence of sexual fighting touching females. The occurrence frequency was assessed with a random-effects model. The heterogeneity was estimated with I 2 values. Differences by research features were assessed over subgroup evaluation and meta-regression.

RESULTS

A total of 32 cross-sectional studies were included (a total of 19,125 participants). The pooled sexual violence rate was 0.29 (95% CI = 0.25-0.34). Subgroup analyses found that there was a higher rate of sexual violence against women in 2010-2019 period (0.33, 95% CI = 0.27-0.37), developing countries (0.32, 95% CI = 0.28-0.37), and interview (0.39, 95% CI = 0.29-0.49). The analysis found that more than half of women (0.56, 95% CI = 0.37-0.75) had post-traumatic stress disorder (PTSD) after experiencing sexual violence, and only a third of women considered seeking support (0.34, 95% CI = 0.13-0.55).

CONCLUSIONS

Nearly one out of every three (29%) women around the world has been a victim of sexual violence in their life. This current study investigated the status and characteristics of sexual violence against women, which could provide an important reference for police and emergency health services management.

Physical Intimate Partner Violence and Maternal Outcomes in a Hospital-Based Sample of Pregnant Women in Jordan

AIM

The purpose of this study was to examine the effect of physical intimate partner violence on maternal pregnancy/ birth outcomes.

METHODS

A cross-sectional, descriptive, comparative design was used. Consecutively, 223 birthing women were chosen. Data was collected in 2014 using the Arabic World Health Organization's Domestic Violence Questionnaire.

RESULTS

Results showed that women who had experienced physical violence during pregnancy had a significantly higher risk of pregnancyinduced hypertension, cesarean section, more pain killer use during birth, and excessive use of postnatal medication.

CONCLUSION

Jordanian health policy makers should find a strategy to eliminate intimate partner violence and reduce its negative impact on women. The inclusion of intimate partner violence screening and identification for every pregnant woman is vital. Sufferers should receive a betterfocused care in order for early detection and treatment of complications that are related to intimate partner violence.

Intimate Partner Violence in the Sub-Saharan African Immigrant Community in Chicago: A Changing Landscape

The challenges of conducting research on intimate partner violence (IPV) in immigrant communities means little is known about the occurrence of various forms of IPV, making it difficult to address in these populations. This research draws on data gathered in Chicago's large and varied African immigrant communities. This research used a mixed methods approach: collection of quantitative survey data on occurrence, followed by qualitative interviews to explain the results. Missing quantitative data and contradicting qualitative responses made it difficult to draw definite conclusions on physical IPV; however, verbal abuse and controlling behaviours appear to be relatively widespread and normalised, and not always viewed as violence. Particularly with the probability of future pandemics and natural disasters, which are known to increase prevalence, it is important to raise awareness of less visible controlling behaviours and verbal abuse as forms of violence, and to implement appropriate prevention programs to minimise a concomitant rise in IPV within African immigrant communities.

Intimate Partner Violence (IPV) Screening and Referral Outcomes among Transgender Patients in a Primary Care Setting

Transgender patients are at elevated risk of intimate partner violence (IPV), but national guidelines do not recommend routine screening for this population. This paper explores the feasibility and effectiveness of routine IPV screening of transgender patients in a primary care setting by describing an existing screening program and identifying factors associated with referral and engagement in IPV-related care for transgender patients. An IPV "referral cascade" was created for 1,947 transgender primary care patients at an urban community health center who were screened for IPV between January 1, 2014 to May 31, 2016: (a) Of those screening positive, how many were referred? (b) Of those referred, how many engaged in IPV-specific care within 3 months? Logistic regression identified demographic correlates of referral and engagement. Of the 1,947 transgender patients screened for IPV, 227 screened positive. 110/227 (48.5%) were referred to either internal or external IPV-related services. Of those referred to on-site services, 65/103 (63.1%) had an IPV-related appointment within 3 months of a positive screen. IPV referral was associated with being assigned male at birth (AMAB) versus assigned female at birth (AFAB) (AOR = 2.69, 95% CI 1.52, 4.75) and with nonbinary, rather than binary, gender identity (AOR = 2.07, 95%CI 1.09, 3.73). Engagement in IPV-related services was not associated with any measured demographic characteristics. Similar to published rates for cisgender women, half of transgender patients with positive IPV screens received referrals and two-thirds of those referred engaged in IPV-specific care. These findings support routine IPV screening and referral for transgender patients in primary care settings. Provider training should focus on how to ensure referrals are made for all transgender patients who screen positive for IPV, regardless of gender identity, to ensure the benefits of screening accrue equally for all patients.

Love in the Time of War: Identifying Neighborhood-level Predictors of Intimate Partner Violence from a Longitudinal Study in Refugee-hosting Communities

A high prevalence of intimate partner violence (IPV) has been documented among women living in conflict-affected and refugee-hosting areas, but why this occurs is not well understood. Conflict and displacement deteriorate communities' social cohesion and community connectedness; these neighborhood social environments may influence individual IPV outcomes. We explored neighborhood-level social disorganization and cohesion as predictors of recent IPV in refugee-hosting communities in northern Ecuador by conducting multi-level logistic regression on a longitudinal sample of 1,312 women. Neighborhood social disorganization was marginally positively associated with emotional IPV (AOR: 1.17, 95% CI: .99, 1.38) and physical and/or sexual IPV (AOR: 1.20, 95% CI: .96, 1.51). This was partially mediated by neighborhood-level civic engagement in the case of emotional IPV. At the household level, perceived discrimination and experience of psychosocial stressors were risk factors for both types of IPV, whereas social support was protective. To our knowledge, this is one of the first studies to examine how neighborhood social factors influence IPV outcomes in refugee-hosting communities or in South America. As the world grapples with the largest number of displaced people in history, this research can inform prevention and response programming and reinforces the critical importance of promoting acceptance of refugees and immigrants and positively engaging all community members in civic life in refugee-hosting settings.

Physical Harm Reduction in Domestic Violence: Does Marijuana Make Assaults Safer?

Studies on the effect of marijuana on domestic violence often suffer from endogeneity issues. To examine the effect of marijuana decriminalization and medical marijuana legalization on serious domestic assaults, we conducted a difference-in-differences analysis on a panel dataset on NIBRS-reported assaults in 24 states over the 12 years between 2005 and 2016. Assaults disaggregated according to situation and extent of injury were employed as dependent variables. We found that while the total number of assaults did not change, decriminalization reduced domestic assaults involving serious injuries by 18%. From a harm reduction perspective, these results suggest that while the extensive margin of violence did not change, the intensive margin measured by the seriousness of assaults were substantially affected by decriminalization. This result may be partially explained by reductions in offender alcohol intoxication and weapon-involved assault.

'So hurt and broken': A qualitative study of experiences of violence and HIV outcomes among Zambian youth living with HIV

Emerging data show associations between violence victimisation and negative HIV outcomes among youth in sub-Saharan Africa. We conducted in-depth interviews with adolescents and young adults living with HIV (aged 15-24 years) in Ndola, Zambia, to better understand this relationship. We purposively selected 41 youth (24 females, 17 males) with varied experiences of violence and virologic results. Analysis used thematic coding. Two-thirds of participants said violence affected their medication adherence, clinic attendance, and/or virologic results. They focused on the negative effects of psychological abuse from family members in homes and peers at schools, which were the most salient forms of violence raised, and sexual violence against females. In contrast, they typically depicted physical violence from caregivers and teachers as a standard discipline practice, with few impacts. Youth wanted HIV clinic settings to address verbal abuse and emotional maltreatment, alongside physical and sexual violence, including through peer mentoring. Violence - especially verbal and emotional forms - must be recognised as a potential barrier to HIV self-management among youth living with HIV in the region. Further testing of clinic, home, and school-based interventions may be critical to reducing levels of violence and improving HIV outcomes in this vulnerable but resilient population.Trial registration: ClinicalTrials.gov identifier: NCT04115813.

Tuition-free secondary education and women's attitudes toward intimate partner violence: Evidence from Sub-Saharan Africa

Intimate partner violence against women (IPVAW) is devastatingly common around the world. It rose further during the pandemic, increasing the urgency of finding interventions to prevent IPVAW and supporting women's ability to exit violent situations. Interventions that prevent violence and eliminate views among perpetrators that violence is acceptable should be top priority. It is also critical to study women's attitudes toward IPVAW as these shape women's responses to the abuse and their exit options. Moreover, research shows that these attitudes have a direct impact on women's health outcomes. We examine the effect of tuition-free secondary education on women's attitudes toward IPVAW across 29 Sub-Saharan African countries using data from the Demographic and Health Surveys conducted between 2000 and 2019. Using the difference-in-difference-in-differences strategy, we estimate the change in women's attitudes toward IPVAW in countries that implement tuition-free secondary policy compared with countries with tuition-free primary alone and those without any tuition-free policy during the study period. We find that while tuition-free primary education policy alone did not reduce the probability of IPVAW being perceived as justified, tuition-free secondary reduced it significantly. The probability that IPVAW was perceived as justified under at least one circumstance declined by 5.3 percentage points more on average in countries that adopted tuition-free policy up to the secondary level relative to those that adopted only up to the primary level. Tuition-free secondary affects four of the five circumstances under which IPVAW was perceived as justified — if she goes out without telling the husband, argues with him, neglects children or refuses sex. We observed no declines for when she burns food, suggesting different factors affecting this outcome. Our findings underscore the importance of making a stronger commitment toward policies that make secondary education more accessible to not only benefit education outcomes but also advance population health.

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Intimate Partner Violence against women (IPVAW) is on the rise globally.

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We examine tuition-free education policy's effect on women's attitudes toward IPVAW.

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Our study exploits variation in the timing of policy rollout in Sub-Saharan Africa.

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Tuition-free primary policy alone did not affect women's attitudes toward IPVAW.

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Tuition-free secondary reduced the probability of IPVAW being perceived as justified.

Italian Validation of the Scale of Psychological Abuse in Intimate Partner Violence (EAPA-P)

Psychological and emotional forms of violence often represent a danger alarm and an important risk factor for other forms of intimate partner violence (IPV). Measuring psychological violence raises several issues of conceptualization and definition, which lead to the development of several assessment instruments; among them, the Scale of Psychological Abuse in Intimate Partner Violence (EAPA-P) showed good psychometric proprieties in a Spanish population and is used to identify which strategies are acted out to engage in psychological violence. The aim of the present study was to investigate the psychometric properties of the Italian version of EAPA-P among a group of Italian-speaking women (N = 343), thus evaluating its psychometric characteristics. Based on the English translation of the original Spanish version, an 11-item form of the EAPA-P was obtained, validity has been assessed through measures of emotion dysregulation, interpersonal guilt, conflict among partners and depression, anxiety, and stress symptomatology. Moreover, differences among groups were conducted to identify the capacity of the Italian version of EAPA-P to discriminate among women reporting experiencing psychological violence (N = 179), and who don't (N = 150). Results showed an excellent internal validity, good correlations, and a good discriminatory ability of the scale. Strengths, limitations, and practical implications of the study have been discussed according to recent literature.

Prevalence and Predictors of Intimate Partner Violence Among Married Women in Egypt

Intimate partner violence (IPV) among married women of childbearing age can significantly enhance their risk of adverse health outcomes such as injury and disability, depression and anxiety, unwanted pregnancies, premature labor, complications with delivery, and perinatal and neonatal mortality. The objective of this study was to examine the prevalence and individual and societal factors associated with IPV among Egyptian women. Cross-sectional data on 12,205 ever-married women between the ages of 15 to 49 years were collected from the Egypt Demographic and Health Survey (EDHS). Data from the 2005 and 2014 EDHS were pooled and analyzed. Self-reported responses on violence by husbands were classified into physical, sexual, and emotional violence. The factors of association were quantified using logistic regression methods. The prevalence of experiencing any form of violence among ever-married women in Egypt was 29.4%. Overall, women reported experiencing physical, emotional, and sexual violence at 26.7%, 17.8%, and 4.6%, respectively. Women in the age group of 25 to 29 years had the highest odds (odds ratio [OR] = 1.539, 95% confidence interval [CI] = [1.327, 1.785]) of suffering from any form of IPV. Women residing in urban areas (OR = 1.149, 95% CI = [1.046, 1.262]), having only a primary-level education (OR = 1.756, 95% CI = [1.543, 1.999]), being followers of Islam (OR = 1.713, 95% CI = [1.379, 2.126]), and having husbands with no education (OR = 1.422, 95% CI = [1.263, 1.601]) reported having higher odds of experiencing any form of IPV. Nearly one third of married women of childbearing age are exposed to IPV of any form in Egypt. IPV intervention programs should pay special attention to the socioeconomically vulnerable segments of the population and promote educational status among men and women to curb the occurrence of IPV.

Maternal emotional and physical intimate partner violence and early child development: investigating mediators in a cross-sectional study in a South African birth cohort

OBJECTIVES

This study investigated associations between recent maternal intimate partner violence (IPV) (emotional, physical and sexual) and child development at 2 years as well as whether maternal depression or alcohol use mediated these relationships.

DESIGN

Cross-sectional study nested in a South African birth cohort.

SETTING

Two primary care clinics in Paarl, South Africa.

PARTICIPANTS

626 mother-child pairs; inclusion criteria for maternal antenatal enrolment were clinic attendance and remaining in the study area for at least 1 year; women were excluded if a minor.

PRIMARY OUTCOME MEASURES

Child cognitive, language and motor development composite scores. These were assessed using the Bayley Scales of Infant and Toddler Development, third edition.

RESULTS

Emotional IPV was associated with lower cognitive (β=-0.32; 95% CI -0.60 to -0.04), language (β=-0.36; 95% CI -0.69 to -0.01) or motor composite scores (β=-0.58; 95% CI -0.95 to -0.20) in children at 2 years of age. Physical IPV was associated with lower motor scores (β=-0.42; 95% CI -0.75 to -0.09) at 2 years. Sexual IPV was unrelated to developmental outcomes, possibly due to low prevalence. Neither recent maternal depression nor alcohol use were shown to mediate the relationship between IPV and developmental outcomes.

CONCLUSIONS

Interventions to reduce maternal physical and emotional IPV and early-life interventions for infants and toddlers are needed to promote optimal child development.

Postpartum Depressive Symptoms as a Mediator Between Intimate Partner Violence During Pregnancy and Maternal-Infant Bonding in Japan

Studies show that experiencing intimate partner violence (IPV) during pregnancy is related to poor maternal-infant bonding. However, the mechanisms underlying this relationship are unclear. This article aims to examine whether maternal postpartum depressive (PPD) symptoms mediate the association between pregnancy IPV and maternal-infant bonding, and whether the relationship differs by maternal-infant bonding subscales-lack of affection, anger/rejection. A survey was conducted among women who participated in a postpartum health check-up program in Aichi prefecture, Japan (N = 6,590) in 2012. We examined whether experiences of emotional and physical IPV were related to maternal-infant bonding and whether PPD symptoms mediated this relationship. Path analysis showed that emotional and physical IPV were associated with PPD symptoms, and PPD symptoms predicted poor bonding. The total effect of emotional IPV on poor bonding was significant, showing a marginally significant direct effect and statistically significant indirect effect. The total effect of physical IPV on poor bonding was not statistically significant. Emotional IPV was significantly associated with both lack of affection and anger/rejection bonding subscales, which were similarly mediated by PPD symptoms. Findings revealed a modest indirect association between IPV, emotional IPV in particular, and poor maternal-infant bonding, which was mediated by PPD symptoms. While prevention of IPV is the ultimate goal, the treatment of PPD symptoms among women who experience IPV during pregnancy may improve maternal-infant bonding and mitigate cross-generational effects of IPV. Identifying opportunities for detection of IPV and PPD symptoms, as well as prevention and early intervention, may improve maternal-infant bonding.

Associations of Emotional, Physical, or Sexual Intimate Partner Violence and Depression Symptoms Among South African Women in a Prospective Cohort Study

Violence against women remains a significant public health problem globally. The majority of longitudinal studies documenting the negative impact of intimate partner violence (IPV) on the mental health of women come from high-income countries. The aim of this study was to investigate the longitudinal association between emotional, physical, or sexual IPV and depression symptoms among South African women in a prospective cohort study. Participants were 981 South African women enrolled in the Drakenstein Child Health Study-a cohort study investigating the early life determinants of child health. Interview data from four time-points (antenatal care visit, 6 months, 12 months, and 18 months postpartum) were included. The primary independent variable was self-reported emotional, physical, and sexual IPV in the past 12 months. Depressive symptoms were assessed at each time-point with the Edinburgh Postnatal Depression Scale (EPDS); a cutoff score of ⩾13 was used to define significant depression symptoms. We used pooled-multivariable logistic regression models to determine associations between the three different forms of IPV and significant depression symptoms while adjusting for time-fixed and time-updated covariates. The mean age of the sample at antenatal care visit was 27 years (standard deviation = 6.0). In the adjusted model including all forms of IPV and adjusting for sociodemographic and clinical characteristics, substance use, and childhood trauma, emotional (adjusted odds ratio [aOR] =1.55, 95% confidence interval (CI): [1.02, 2.34]; p = .039)] and sexual (aOR = 2.02, 95% CI: [1.10, 3.72]; p < .001) IPV were significantly associated with significant depression symptoms. The relationship between physical IPV and significant depression symptoms was not statistically significant (aOR = 0.68, 95% CI: [0.44, 1.05]; p = .485). Our study confirms findings from high-income countries of the association between IPV and depressive symptoms among women in South Africa. Routine screening for IPV, including emotional IPV and intervention programs for IPV among women, is needed in South Africa.

Exploring Intimate Partner Violence Before, During, and After Pregnancy in Bangladesh

Intimate partner violence (IPV) against pregnant or postpartum women is known to have multiple detrimental effects on women and their children. Although results from past research suggest much continuity in trajectories of IPV, it is unclear whether pregnancy interrupts or augments these patterns. Little is known about how physical, sexual, and psychological IPV change and overlap throughout a woman's transition to parenthood. Relying on population-based data, this study examines the prevalence, co-occurring nature, and the changing patterns of physical, sexual, and psychological IPV before, during, and after pregnancy in Bangladesh. Cross-sectional survey data were collected between October 2015 and January 2016 in the Chandpur District of Bangladesh from 426 new mothers, aged 15 to 49 years, who were in the first 6 months postpartum. IPV was assessed with a validated set of survey items. The frequencies of different types of IPV victimization according to the period of occurrence were calculated separately and in a cumulative, co-occurring manner. The prevalence of physical IPV before, during, and after pregnancy was 52.8%, 35.2%, and 32.2%, respectively. The comparative figures for psychological IPV were 67.4%, 65%, and 60.8%, and for sexual IPV were 21.1%, 18.5%, and 15.5%, respectively. The results demonstrate a notable continuity in IPV victimization before, during, and after pregnancy. Psychological IPV is the only type to exhibit a significant reduction during and after pregnancy, compared with before pregnancy, but it commonly overlaps with physical IPV, which shows a significant change during pregnancy and little change in the postpartum period. At the same time, pregnancy and childbirth offer little protection against IPV for women in relationships characterized by psychological or sexual victimization, both of which commonly overlap with physical IPV. Results reinforce the need to conduct routine screening during pregnancy to identify women with a history of IPV and to offer necessary help and support.

Validation of the Psychological Maltreatment of Women Inventory for Chinese Women

This study aimed to revise and validate a Chinese version of Psychological Maltreatment of Women Inventory (C-PMWI). In the preparation phase, the PMWI was first revised for the possible cultural differences between Chinese and non-Chinese women. Supplementary items on use of electronic devices as a contemporary form of monitoring were added. Forward and back translated items were reviewed by a panel of intimate partner violence (IPV) experts, resulting in the scale-level content validity index of 0.94. Cognitive debriefing was conducted to confirm comprehensibility. The newly revised measure was administered to the sample of 1,198 Chinese women, recruited from community centers and shelters in Hong Kong. Exploratory factor analysis conducted on data from half the sample revealed a two-factor structure similar to the original English version: emotional-verbal and dominance-isolation. This structure was verified by confirmatory factor analysis with the other half of the sample. Known-groups validity was demonstrated by significant differences in scores between women with different relationship histories. Moderate-to-strong correlations of the C-PMWI with other forms of IPV, controlling behaviors, relationship satisfaction, and depression established convergent validity. The C-PMWI showed good internal consistency, with Cronbach's alpha >.9 for the entire scale and each subscale. The intraclass correlation across administrations 2 weeks was >.9, demonstrating test-retest reliability. The use of the comprehensive validation procedures in the present study provided evidence for both cultural appropriateness and satisfactory psychometric properties of the C-PMWI. The C-PMWI shows promise as a useful instrument for research and clinical practice with Chinese women.

Association Between Dating Violence and Behavioral and Health Outcomes Among Early Adolescents From Denmark: The Role of Exposure to Childhood Maltreatment

AIM

To examine the unique contribution of child maltreatment victimization on the association between adolescent dating violence (ADV) and four negative behavioral and health-related factors.

METHOD

In total, 2,934 7th grade students (M = 13.5, SD = .5) filled out questionnaires at school. Binominal logistic regression was performed to assess the impact of child maltreatment on the relationship between ADV and behavioral and health-related factors.

RESULTS

After child maltreatment was taken into account, associations between ADV and the negative behavioral and health-related factors became weaker.

CONCLUSIONS

The findings from the present study suggest that focusing on one victimization type (such as ADV) when examining psychological outcomes, can be problematic as the causal relationship may be misrepresented when an adolescent's broader victimization profile and context is not considered.

Intimate partner violence polyvictimisation and HIV among coupled women in Zambia: Analysis of a population-based survey

Women in sub-Saharan Africa are disproportionately at risk for the dual epidemics of intimate partner violence (IPV) and HIV. Little is known about how specific violence profiles affect women's HIV risk, limiting effective intervention. We analysed couples' data from the Zambia Demographic and Health Survey 2013-2014 to evaluate relationships among IPV, male partner HIV status and women's HIV status. We considered the individual and combined effects of physical, sexual, emotional, and high controlling behaviour violence and accumulated violence exposure, respectively. Among partnered women, 48.9% (n = 2,812) experienced IPV victimisation, of whom 52.1% (n = 1,465) reported polyvictimisation (experiencing two or more violence types). Female HIV prevalence was 13.2%. Adjusted for demographics, HIV was significantly higher for women who experienced three (17.3%, aPR 1.33, 95%CI: 1.04-1.69, p = 0.02) or four (22.1%, aPR 1.66, 95%CI: 1.23-2.26, p ≤ 0.01) types versus no IPV. Violence including emotional and/or high controlling victimisation was associated with female HIV infection (aPR: 1.31, 95%CI: 1.09-1.57, p = 0.01). Physical and/or sexual violence victimisation in the absence of other victimisation was not associated with HIV (aPR: 0.92, 95%CI:0.73-1.15, p = 0.46). IPV and HIV interventions are incomplete without addressing emotional and controlling IPV and the role of coercive relationship dynamics in transmission risk.

Gender (A)Symmetry in Correlates of Perpetration of Intimate Partner Violence: Gender (A) Symmetry in IPV and the Role of Gender Attitudes

This study examined, using structural equation modeling (SEM), gender differences and similarities in correlates of the perpetration of emotional aggression against intimate partners among one of the largest groups of Asian Indians in the United States, Gujaratis. Although most of the correlates of emotional aggression (e.g., patriarchal attitudes, spousal disagreement, and alcohol use) were similar for men and women, higher support for gendered domestic roles was significantly related to higher perpetration of emotional aggression for men but not for women. Multigroup latent SEM served as a unique analytical strategy to investigate gender (a)symmetry, a controversial but critical debate in the field.

Measuring psychological abuse by intimate partners: Constructing a cross-cultural indicator for the Sustainable Development Goals

Psychological abuse within intimate relationships is linked to negative health outcomes among women and is frequently identified as more wounding than physical or sexual violence. There is little agreement, however, on how to conceptualize or measure the phenomenon, despite measurement being necessary to estimate the prevalence of psychological abuse, establish its interaction with physical and sexual violence, assess its health impacts, and monitor progress towards global Sustainable Development Goals. To address this gap, we used latent class analysis (LCA), psychometric testing, and logistic regression to evaluate the construct and content validity of alternative methods for deriving a measure of psychological partner abuse, using pooled data from the first 10 countries and 15 sites of the World Health Organization Multi-Country Study on Domestic Violence and Women's Health (WHO MCS). Our analysis finds that psychological abuse is highly prevalent, ranging from 12% to 58% across countries. A three-class solution was supported for coding psychological abuse: none, moderate-intensity abuse, and high-intensity abuse. This three-level categorization, which can be coded without LCA, demonstrates a clear graded relationship with controlling behaviors and all measured health outcomes except physical pain. Factor analysis confirms that psychological abuse and male controlling behaviors are separate constructs as measured in the WHO MCS and the Demographic and Health Surveys and should not be combined. We conclude that this is a simple way to code psychological abuse for cross-country comparison. Its use could support urgently needed research into psychological abuse across settings and identify an appropriate threshold for defining psychological violence for surveys globally.

Intimate Partner Violence, Childhood Abuse, and In-Law Abuse Among Women Utilizing Community Health Services in Gujarat, India

Previous studies in India suggest high prevalence of intimate partner violence (IPV), childhood abuse, and abuse from in-laws. Yet few studies examined IPV, childhood abuse, and abuse from in-laws together. The purpose of this study is to examine the association between IPV, childhood abuse, and abuse from in-laws, and types of abuse (physical, sexual, and emotional abuse) among women utilizing community health services for the economically disadvantaged in India. This study contributes to expanding the literature on abuse experience and providing knowledge for developing intervention programs and research projects to improve health and safety of economically disadvantaged women. The data were collected from women aged 18 years old or older at 18 community health centers that are primarily for the economically disadvantaged in Gujarat, India, in October and November 2013. Of the 219 women who completed a self-administered survey, 167 participants, who had ever been married and indicated whether they had been abused by their spouse or not, were included in analysis. More than 60% of the participants experienced IPV, childhood abuse, and/or abuse from in-laws, often with multiple types of abuse. Physical abuse is a major issue for IPV, childhood abuse, and in-law abuse. Emotional abuse potentially happens along with physical and/or sexual abuse. Abuse from in-laws requires greater attention because all types of abuse from in-laws were associated with IPV. Community health centers should provide abuse prevention and intervention programs that have involvement of family members as well as women who are at risk of being abused.

Principles of care for women experiencing intimate partner violence: Views of expert Japanese health professionals and advocates

In Japan, interventions for Intimate Partner Violence (IPV) in the health care setting are rare, partly due to Japanese cultural norms that marginalize women's IPV experiences. A thematic analysis of narratives of eight Japanese health professionals who are experts in IPV care identified shared core values and practices that have guided their development of culturally relevant IPV interventions: supporting women's autonomy to define what is at stake for her, appreciating unique trajectories and timing for recovery, and practicing shared decision-making. These shared practices may be essential for training health professionals to respond to IPV in Japan and elsewhere.

Factors Associated With Domestic Violence Against Women in Iran: An Exploratory Multicenter Community-Based Study

Domestic violence against women committed by intimate partners is a worldwide concern especially in developing countries. The aim of this study was to assess the problem among Iranian women and identify associated risk factors. Using a cross-sectional multicenter design, 1,600 women in six different areas of Iran were surveyed. A measure of domestic violence against women was administered and demographic information collected. Logistic regression models were used to identify factors associated with domestic violence. The prevalence of domestic violence among participants were emotional (64%), physical (28%), and sexual (18%). Higher education (both women and their partners), employment status of partner (being employed), and lower number of children lowered the risk, whereas history of previous marriage (for either women or their partners), unstable marriage, substance abuse, crowded family situation, and lower socioeconomic status increased the risk of domestic violence. There is a high prevalence of domestic violence, particularly emotional, against women by their partners. Preventive measures are recommended such as increasing public awareness, improving in socioeconomic status of families, educating women about what they can do, and encouraging counseling for the couple or the woman alone.

Depression and intimate partner violence among college students in Iran

Intimate partner violence (IPV) is a significant public health threat and causes mental as well as physical health problems. Depression is a common mental health consequence of IPV. While Iran has a high prevalence of IPV and depression, the association between IPV and depression has not been well examined. The Iranian data from the International Dating Violence Study (IDVS) 2001-2006 (ICPSR 29583) were analyzed. Twenty-three male and 75 female college students were selected in the IDVS Iranian data. Nearly all of the participants, male and female, reported being victims and perpetrators of IPV. Female participants were more likely to report depression compared to male participants. Participants who had experienced sexual IPV reported significantly higher levels of depression compared to those who did not experience sexual IPV. However, when substance abuse and partner conflict were analyzed, the contribution of sexual IPV on depression was no longer significant. This study suggests that IPV prevention and intervention programs should take into consideration that college-aged men and women frequently experience and use violence in dating relationships. Depression interventions should be included for female students. Substance abuse and partner conflict are important risk factors for depression.

The impact of SASA!, a community mobilisation intervention, on women's experiences of intimate partner violence: secondary findings from a cluster randomised trial in Kampala, Uganda

BACKGROUND

Intimate partner violence (IPV) is a global public health and human rights concern, though there is limited evidence on how to prevent it. This secondary analysis of data from the SASA! Study assesses the potential of a community mobilisation IPV prevention intervention to reduce overall prevalence of IPV, new onset of abuse (primary prevention) and continuation of prior abuse (secondary prevention).

METHODS

A pair-matched cluster randomised controlled trial was conducted in 8 communities (4 intervention, 4 control) in Kampala, Uganda (2007-2012). Cross-sectional surveys of community members, 18-49 years old, were undertaken at baseline (n=1583) and 4 years postintervention implementation (n=2532). Outcomes relate to women's past year experiences of physical and sexual IPV, emotional aggression, controlling behaviours and fear of partner. An adjusted cluster-level intention-to-treat analysis compared outcomes in intervention and control communities at follow-up.

RESULTS

At follow-up, all types of IPV (including severe forms of each) were lower in intervention communities compared with control communities. SASA! was associated with lower onset of abuse and lower continuation of prior abuse. Statistically significant effects were observed for continued physical IPV (adjusted risk ratio 0.42, 95% CI 0.18 to 0.96); continued sexual IPV (0.68, 0.53 to 0.87); continued emotional aggression (0.68, 0.52 to 0.89); continued fear of partner (0.67, 0.51 to 0.89); and new onset of controlling behaviours (0.38, 0.23 to 0.62).

CONCLUSIONS

Community mobilisation is an effective means for both primary and secondary prevention of IPV. Further support should be given to the replication and scale up of SASA! and other similar interventions.

TRIAL REGISTRATION NUMBER

NCT00790959.

The impact of SASA!, a community mobilisation intervention, on women's experiences of intimate partner violence: secondary findings from a cluster randomised trial in Kampala, Uganda

BACKGROUND

Intimate partner violence (IPV) is a global public health and human rights concern, though there is limited evidence on how to prevent it. This secondary analysis of data from the SASA! Study assesses the potential of a community mobilisation IPV prevention intervention to reduce overall prevalence of IPV, new onset of abuse (primary prevention) and continuation of prior abuse (secondary prevention).

METHODS

A pair-matched cluster randomised controlled trial was conducted in 8 communities (4 intervention, 4 control) in Kampala, Uganda (2007-2012). Cross-sectional surveys of community members, 18-49 years old, were undertaken at baseline (n=1583) and 4 years postintervention implementation (n=2532). Outcomes relate to women's past year experiences of physical and sexual IPV, emotional aggression, controlling behaviours and fear of partner. An adjusted cluster-level intention-to-treat analysis compared outcomes in intervention and control communities at follow-up.

RESULTS

At follow-up, all types of IPV (including severe forms of each) were lower in intervention communities compared with control communities. SASA! was associated with lower onset of abuse and lower continuation of prior abuse. Statistically significant effects were observed for continued physical IPV (adjusted risk ratio 0.42, 95% CI 0.18 to 0.96); continued sexual IPV (0.68, 0.53 to 0.87); continued emotional aggression (0.68, 0.52 to 0.89); continued fear of partner (0.67, 0.51 to 0.89); and new onset of controlling behaviours (0.38, 0.23 to 0.62).

CONCLUSIONS

Community mobilisation is an effective means for both primary and secondary prevention of IPV. Further support should be given to the replication and scale up of SASA! and other similar interventions.

TRIAL REGISTRATION NUMBER

NCT00790959.

Violence Against Women in Selected Areas of the United States

OBJECTIVES

We determined the prevalence of recent emotional, physical, and sexual violence against women and their associations with HIV-related risk factors in women living in the United States.

METHODS

We performed an assessment of women ages 18 to 44 years with a history of unprotected sex and 1 or more personal or partner HIV risk factors in the past 6 months from 2009 to 2010. We used multivariable logistic regression to examine the association of experiencing violence.

RESULTS

Among 2099 women, the prevalence of emotional abuse, physical violence, and sexual violence in the previous 6 months was 31%, 19%, and 7%, respectively. Nonmarried status, food insecurity, childhood abuse, depression symptomology, and posttraumatic stress disorder were significantly associated with multiple types of violence. All types of violence were associated with at least 3 different partner or personal HIV risk behaviors, including unprotected anal sex, previous sexually transmitted infection diagnosis, sex work, or partner substance abuse.

CONCLUSIONS

Our data suggested that personal and partner HIV risk behaviors, mental illness, and specific forms of violence frequently co-occurred in the lives of impoverished women. We shed light on factors purported to contribute to a syndemic in this population. HIV prevention programs in similar populations should address these co-occurring issues in a comprehensive manner.

An Introspective Approach to Nursing Intimate Partner Violence Victims in Japan

BACKGROUND AND AIMS

The number of intimate partner violence (IPV) cases has been increasing in Japan since the 1990s. Many victims tend to hide their victimization and conceal their clinic or hospital visits. In these cases, nurses face feelings of incongruity toward patients. We aimed to explore if the process of introspection can provide better care for patients who have experienced IPV and prevent burnout in nurses. We hypothesized that introspection training would have a positive effect on nursing interventions.

METHODS

We interviewed Japanese nurses who handled IPV cases between 2006 and 2009 and analyzed responses on the Emotional Question Scale (EQS). We used a modified grounded theory approach to analyze narratives from 20 nurses.

RESULTS

We found that nurses experienced difficulties in coping with their incongruence toward patients, did not always feel capable of IPV care, and lacked experience in caring for patients experiencing IPV. Introspection training did not lead to significant differences in EQS scores, although scores on the self-management, interpersonal management, and situation management subscales were correlated significantly. This indicated that utilizing the introspection process would result in EQS improvement.

CONCLUSION

We concluded that the process of objectification of incongruity is effective in detecting hidden IPV and helpful in identifying negative feelings, thus preventing burnout in nurses.

Recent intimate partner violence among people with chronic mental illness: findings from a national cross-sectional survey

BACKGROUND

People with mental illness are at increased risk of intimate partner violence (IPV) victimisation, but little is known about their risk for different forms of IPV, related health impact and help-seeking.

AIMS

To estimate the odds for past-year IPV, related impact and disclosure among people with and without pre-existing chronic mental illness (CMI).

METHOD

We analysed data from 23 222 adult participants in the 2010/2011 British Crime Survey using multivariate logistic regression.

RESULTS

Past-year IPV was reported by 21% and 10% of women and men with CMI, respectively. The adjusted relative odds for emotional, physical and sexual IPV among women with versus without CMI were 2.8 (CI = 1.9-4.0), 2.6 (CI = 1.6-4.3) and 5.4 (CI = 2.4-11.9), respectively. People with CMI were more likely to attempt suicide as result of IPV (aOR = 5.4, CI = 2.3-12.9), less likely to seek help from informal networks (aOR = 0.5, CI = 0.3-0.8) and more likely to seek help exclusively from health professionals (aOR = 6.9, CI = 2.6-18.3).

CONCLUSIONS

People with CMI are not only at increased risk of all forms of IPV, but they are more likely to suffer subsequent ill health and to disclose exclusively to health professionals. Therefore, health professionals play a key role in addressing IPV in this population.

Domestic and sexual violence against patients with severe mental illness

BACKGROUND

Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population.

METHOD

Three hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾ 1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey.

RESULTS

Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7-4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0-2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4-5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001).

CONCLUSIONS

Compared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.

Cross-cultural measurement equivalence of the Japanese version of Revised Conflict Tactics Scales Short Form among Japanese men and women

AIM

The Revised Conflict Tactics Scales Short Form (CTS2SF) is an instrument used to measure intimate partner violence (IPV) perpetration and victimization over the past 12 months.

METHODS

The CTS2SF was translated into Japanese, and the reliability (internal consistency and 4-week test-retest reliability) and the concurrent and factor-based validity were examined using two waves of Internet surveys over an interval of 4 weeks. Participants of the survey were 393 Japanese men and women who were registrants of an Internet survey company.

RESULTS

Cronbach's α was greater than 0.5 for most scales, while it was low (α = 0.18) for sexual coercion by partner. The test-retest reliability of the binary variable for the presence or absence of IPV was high (Yule's Q, 0.79-1.00), and moderate between the scores (Spearman's rank correlation, 0.38:0.70). Concordance with the Buss-Perry Aggression Questionnaire, Violence Against Women Screen, and Kessler 6 generally indicated good concurrent validity. The results of the exploratory factor analysis confirmed the three-factor structure of the Japanese version of the CTS2SF.

CONCLUSION

Although the internal consistency reliability was limited for some sub-scales, its moderate internal consistency and test-retest reliability and good factor-based validity highlighted the benefit of using the Japanese version of the CTS2SF in a large-scale community survey where a shorter scale is required to assess IPV.

Intimate partner violence and physical and mental health among women utilizing community health services in Gujarat, India

Background

Intimate partner violence (IPV) is a significant public health threat which causes injury and acute and chronic physical and mental health problems. In India, a high percentage of women experience IPV. The purposes of this study include 1) to describe the lifetime prevalence of IPV, and 2) to examine the association between IPV and physical and mental health well-being, among women utilizing community health services for the economically disadvantaged in India.

Methods

Women utilizing community health services (N = 219) aged between 18 and 62 years completed a self-administered survey in Gujarat, India. Standardized instruments were used to measure perceived physical and mental health well-being. In addition, participants were asked about their lifetime experience with IPV, and socio-demographic questions. Analysis was restricted to the ever-married participants who completed the questions on IPV (N = 167).

Results

Participants with a lifetime history of IPV were more likely to have reported poorer physical and mental health compared to those without a lifetime history of IPV. More than half of the participants with an IPV history experienced multiple types of IPV (physical, sexual and/or emotional IPV). While being in the highest caste was a significant positive factor associated with better health, caste and other socio-demographic factors were not associated with IPV.

Conclusions

Women in India face risk of IPV. Yet those experiencing IPV do not seek help or rely on informal help sources. Community health organizations may take a role in IPV prevention and intervention. Diversity of intervention options would be important to encourage more women with IPV experience to seek help.

"I Just Keep My Antennae Out": How Rural Primary Care Physicians Respond to Intimate Partner Violence

Women in rural communities who are exposed to intimate partner violence (IPV) have fewer resources when seeking help due to limited health services, poverty, and social isolation. Rural primary care physicians may be key sources of care for IPV victims. The objective of this study was to assess the opinions and practices of primary care physicians caring for rural women with regard to IPV identification, the scope and severity of IPV as a health problem, how primary care providers respond to IPV in their practices, and barriers to optimized IPV care in their communities. Semistructured interviews were conducted with 19 internists, family practitioners, and obstetrician-gynecologists in rural central Pennsylvania. Interview transcripts were analyzed for major themes. Most physicians did not practice routine screening for IPV due to competing time demands, lack of training, limited access to referral services as well as low confidence in their effectiveness, and concern that inquiry would harm the patient-doctor relationship. IPV was considered when patients presented with symptoms of mood, anxiety, or somatic disorders. Responses to IPV included validation, danger assessment, safety planning, referral, and follow-up planning. Perceived barriers to rural women seeking help for IPV included traditional gender roles, lower education, economic dependence on the partner, low self-esteem, and patient reluctance to discuss IPV. To overcome barriers, physicians created a "safe sanctuary" to discuss IPV and suggested improved public health education and referral services. Interventions to improve IPV-related care in rural communities should address barriers at multiple levels, including both physicians' and patients' comfort with discussing IPV. Provider training, community education, and improved access to referral services are key areas in which IPV-related care should be improved in rural communities. Our data support routine screening to better identify IPV and a more pro-active stance toward screening and counseling.

Factors Affecting Initial Intimate Partner Violence-Specific Health Care Seeking in the Tokyo Metropolitan Area, Japan

This study examined the factors affecting a women's initial intimate partner violence (IPV)-specific health care seeking event which refers to the first health care seeking as a result of IPV in a lifetime. Data were collected using the Life History Calendar method in the Tokyo metropolitan area from 101 women who had experienced IPV. Discrete-time survival analysis was used to assess the time to initial IPV-specific health care seeking. IPV-related injury was the most significant factor associated with increased likelihood of seeking IPV-specific health care seeking for the first time. In the presence of a strong effect of formal help seeking, physical and sexual IPV were no longer significantly related to initial IPV-specific health care seeking. The results suggest some victims of IPV may not seek health care unless they get injured. The timing of receiving health care would be important to ensure the health and safety of victims.

Assessing the Risk of Intimate Partner Violence in the Chinese Population

The study undertook the development and validation of a risk assessment tool for the evaluation of risk of intimate partner violence (IPV) among the Chinese population. A total of 2,225 men from a representative Chinese population in Hong Kong were assessed with their experience of IPV perpetration in the year preceding the interview. With the use of the split-half validation procedure, six factors that were associated with IPV perpetration were selected. The area under the receiver operating characteristic curve (AUC) was 0.76. The Chinese Risk Assessment Tool for Perpetrators (CRAT-P) is a brief and easy to use assessment tool for evaluating IPV risk in the Chinese population.

Intimate partner violence victimization and alcohol consumption in women: a systematic review and meta-analysis

AIMS

To examine the evidence of association between intimate partner physical or sexual violence (IPV) victimization and alcohol consumption in women.

METHODS

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies released before 6 June 2013. Studies providing an estimate of association between violence and alcohol consumption or alcohol use disorders were eligible for inclusion. Quality was assessed and random effects meta-analyses used to generate pooled odds ratios (OR) where appropriate. Higgins I(2) where P<0.10 was taken to indicate heterogeneity.

RESULTS

Fifty-five studies providing 102 estimates of association met the inclusion criteria. Most estimates were not controlled for partner alcohol use and other key confounders. Seven longitudinal studies provided 12 estimates of the association between alcohol and subsequent IPV; nine of 12 estimates showed a direction of increased odds of subsequent IPV, pooled OR=1.27 [95% confidence interval (CI)=1.07-1.52], I(2) =0%, P=0.437. Nine longitudinal studies provided 15 estimates of association between IPV and subsequent alcohol use; 14 of 15 estimates showed a direction of increased odds of subsequent alcohol use, pooled OR=1.25 (95% CI 1.02-1.52), I(2)=0%, P=0.751. Cross-sectional studies showed an association between IPV and alcohol use, pooled OR=1.80, 95% CI 1.58-2.06, but with substantial heterogeneity, I(2)=60.8%, P<0.0001. Definition of alcohol use partly accounted for heterogeneity in cross-sectional estimates.

CONCLUSIONS

There is a clear positive association between alcohol use and intimate partner physical or sexual violence victimization among women, suggesting a need for programming and research that addresses this link. However, the temporal direction of the association remains unclear. Longitudinal studies with multiple waves of data collection are needed.

Relational trauma and posttraumatic stress symptoms among pregnant women

Women experience remarkably high rates of relational trauma including childhood abuse and neglect and intimate partner violence (IPV) during adulthood, and the childbearing years are no exception. The meaning of past and current relational trauma perpetrated by primary caregivers and significant others may be unique during pregnancy, in particular, because pregnancy is a salient time when mothers' important relationships are reworked and reorganized to "make room" for the relationship with the baby. The present study examined associations between different forms of relational trauma and posttraumatic stress symptoms in 120 women during the last trimester of pregnancy. Women were between the ages of 18 and 42 years and came from diverse economic and ethnic backgrounds. Results indicated that severity of childhood maltreatment was significantly related to severity of IPV during pregnancy, and both types of trauma made unique, significant contributions to posttraumatic stress symptoms. Furthermore, emotional/psychological violence had the largest associations with posttraumatic stress symptoms compared to other forms of violence. Findings indicate that it is critically important for clinicians working with pregnant women to conduct a thorough assessment of current and past relational trauma, including emotional/psychological trauma, in order to improve the well-being of the mother, the infant, and the mother-infant relationship.

Screening on perpetration and victimization of intimate partner violence (IPV): two studies on the validity of an IPV screening instrument in patients in substance abuse treatment

Background

About 50% of patients in substance abuse treatment with a partner perpetrated and/or experienced intimate partner violence in the past year. To date, there are no screeners to identify both perpetrators and victims of partner intimate violence in a substance abusing population. We developed a 4 item screening instrument for this purpose, the Jellinek Inventory for assessing Partner Violence (J-IPV). Important strengths of the J-IPV are that it takes only 2 minutes to administer and is easy to use and to score.

Methods

To investigate the validity of the J-IPV, two independent studies were conducted including 98 and 99 participants, respectively. Aim of the second study was to cross-validate findings from the first study. Psychometric properties of the J-IPV were determined by calculating sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio’s by comparing J-IPV outcomes to outcomes on the Revised Conflict Tactics Scales (‘gold standard’). Also, receiver operator characteristics (ROC)-curves were determined to weight sensitivity and specificity as a result of different J-IPV cutoffs, and the area under the curve (AUC) was calculated.

Results

Results of the first study demonstrated that the J-IPV possesses good psychometric properties to detect perpetrators and victims of any as well as severe intimate partner violence. Results from the second study replicated findings from the first study.

Conclusions

We recommend administering the J-IPV to patients entering substance abuse treatment. If perpetrators and victims of partner violence are identified, action can be taken to stop IPV perpetration and arrange help for victims, for example by offering perpetrators treatment or by providing safety planning or advocacy interventions to victims.

Intimate partner violence and cardiovascular risk in women: a population-based cohort study

BACKGROUND

A potential link between intimate partner violence (IPV) and cardiovascular disease (CVD) has been suggested, yet evidence is scarce. We assessed cardiovascular risk and incident prescription of cardiovascular medication by lifetime experiences of physical and/or sexual IPV and psychological IPV alone in women.

METHODS

A population-based cohort study of women aged 30-60 years was performed using cross-sectional data and clinical measurements from the Oslo Health Study (2000-2001) linked with prospective prescription records from the Norwegian Prescription Database (January 1, 2004 to December 31, 2009). We used age-standardized chi-square analyses to compare clinical characteristics by IPV cross-sectionally, and Cox proportional hazards regression to examine cardiovascular drug prescription prospectively.

RESULTS

Our study included 5593 women without cardiovascular disease or drug use at baseline. Altogether 751 (13.4%) women disclosed IPV experiences: 415 (7.4%) physical and/or sexual IPV and 336 (6.0 %) psychological IPV alone. Cross-sectional analyses showed that women who reported physical and/or sexual IPV and psychological IPV alone were more often smokers compared with women who reported no IPV. Physical and/or sexual violence was associated with abdominal obesity, low high-density lipoprotein cholesterol, and elevated triglycerides. The prospective analysis showed that women who reported physical and/or sexual IPV were more likely to receive antihypertensive medication: incidence rate ratios adjusted for age were 1.27 (95% confidence interval 1.02-1.58) and 1.36 (CI 1.09-1.70) after additional adjustment for education and systolic and diastolic blood pressure, respectively. No significant differences were found for cardiovascular drugs overall or lipid modifying drugs.

CONCLUSIONS

Our findings indicate that clinicians should assess the cardiovascular risk of women with a history of physical and/or sexual IPV, and consider including CVD prevention measures as part of their follow-up.

Intimate Partner Violence and Mental Health Among Italian Adolescents

Only a few studies have analyzed the health impact of intimate partner violence (IPV) on male and female adolescents, taking into account other kinds of violence that can affect their health. In this study, 43.7% of female adolescents and 34.8% of males reported IPV; females reported more psychological and sexual IPV, with no differences for physical IPV. Controlling for family and sexual violence and other confounding factors, female adolescents exposed to IPV had significantly higher adjusted odds ratios (AORs) for depression, panic attacks, eating problems, and suicidal ideation. For male adolescents, only the OR of eating problems almost reached statistical significance.

Mental and Physical Health and Intimate Partner Violence against Women: A Review of the Literature

Associations between intimate partner violence (IPV) and poor physical and mental health of women have been demonstrated in the international and national literature across numerous studies. This paper presents a review of the literature on this topic. The 75 papers included in this review cover both original research studies and those which undertook secondary analyses of primary data sources. The reviewed research papers published from 2006 to 2012 include quantitative and qualitative studies from Western and developing countries. The results show that while there is variation in prevalence of IPV across various cultural settings, IPV was associated with a range of mental health issues including depression, PTSD, anxiety, self-harm, and sleep disorders. In most studies, these effects were observed using validated measurement tools. IPV was also found to be associated with poor physical health including poor functional health, somatic disorders, chronic disorders and chronic pain, gynaecological problems, and increased risk of STIs. An increased risk of HIV was reported to be associated with a history of sexual abuse and violence. The implications of the study findings in relation to methodological issues, clinical significance, and future research direction are discussed.

Intimate partner violence and socioeconomic deprivation in England: findings from a national cross-sectional survey

OBJECTIVES

We examined the prevalence of intimate partner violence (IPV) and its association with social deprivation in England.

METHODS

We used multivariable logistic regression to investigate IPV correlates among 21 226 men and women aged 16 to 59 years in the 2008 nationally representative cross-sectional British Crime Survey.

RESULTS

Lifetime IPV was reported by 23.8% of women and 11.5% of men. Physical IPV was reported by 16.8% and 7.0%, respectively; emotional-only IPV was reported by 5.8% and 4.2%, respectively. After adjustment for demographic confounders, lifetime physical IPV experienced by women was associated with social housing tenure (odds ratio [OR] = 2.3; 95% confidence interval [CI] = 2.0, 2.7), low household income (OR = 2.2; 95% CI = 1.8, 2.7), poor educational attainment (OR = 1.2; 95% CI = 1.0, 1.5), low social class (OR = 1.5; 95% CI = 0.3, 1.7), and living in a multiply deprived area (OR = 1.4; 95% CI = 1.1, 1.7). Physical IPV experienced by men and emotional IPV experienced by either gender were generally not associated with deprivation factors.

CONCLUSIONS

Physical and emotional IPV are very common among adults in England. Emotional IPV prevention policies may be appropriate across the social spectrum; those for physical IPV should be particularly accessible to disadvantaged women.

The role of Chinese face in the perpetration of dating partner violence

This study explored the associations between the perpetration of partner violence and two types of face orientation-protective and acquisitive-in Chinese societies. Data from a convenience sample of 3,388 university students from Hong Kong, Shanghai, and Beijing were analyzed. The participants completed the Protective and Acquisitive Face Orientation (PAFO) Scale Short Form and the Revised Conflict Tactics Scale (CTS2) to measure their face orientations and experience of perpetrating violence against their dating partner. Acquisitive face orientation (AFO) was positively associated with the self-reported perpetration of physical and psychological partner violence. No significant associations were found between protective face orientation (PFO) and partner violence perpetration. Gender differences were found across all types of dating violence. City of residence, age, and SES were also associated with partner violence in specific ways. The findings gave insights on the possible mechanisms between partner violence and the concept of face to be explored in future research.